The Impact of COVID-19 on the Delivery of Systemic Anti-Cancer Treatment at Guy’s Cancer Centre

Background: This study aimed to assess the outcome of cancer patients undergoing systemic anti-cancer treatment (SACT) at our centre to help inform future clinical decision-making around SACT during the COVID-19 pandemic. Methods: Patients receiving at least one episode of SACT for solid tumours at Guy’s Cancer Centre between 1 March and 31 May 2020 and the same period in 2019 were included in the study. Data were collected on demographics, tumour type/stage, treatment type (chemotherapy, immunotherapy, biological-targeted) and SARS-CoV2 infection. Results: A total of 2120 patients received SACT in 2020, compared to 2449 in 2019 (13% decrease). From 2019 to 2020, there was an increase in stage IV disease (62% vs. 72%), decrease in chemotherapy (42% vs. 34%), increase in immunotherapy (6% vs. 10%), but similar rates of biologically targeted treatments (37% vs. 38%). There was a significant increase in 1st and 2nd line treatments in 2020 (68% vs. 81%; p < 0.0001) and reduction in 3rd and subsequent lines (26% vs. 15%; p = 0.004) compared to 2019. Of the 2020 cohort, 2% patients developed SARS-CoV2 infections. Conclusions: These real-world data from a tertiary Cancer Centre suggest that despite the challenges faced due to the COVID-19 pandemic, SACT was able to be continued without any significant effects on the mortality of solid-tumour patients. There was a low rate (2%) of SARS-CoV-2 infection which is comparable to the 1.4%-point prevalence in our total cancer population.

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Viennese risk prediction score for Advanced Gastroesophageal carcinoma based on Alarm Symptoms (VAGAS score): characterisation of alarm symptoms in advanced gastro-oesophageal cancer and its correlation with outcome

ESMO Open ◽

10.1136/esmoopen-2019-000623 ◽

2020 ◽

Vol 5 (2) ◽

pp. e000623

Author(s):

Hannah Christina Puhr ◽

Eleonore Pablik ◽

Anna Sophie Berghoff ◽

Gerd Jomrich ◽

Sebastian Friedrich Schoppmann ◽

...

Keyword(s):

Risk Prediction ◽

Oesophageal Cancer ◽

Clinical Decision Making ◽

Stage Iv ◽

Clinical Decision ◽

Prediction Score ◽

Prognostic Information ◽

Initial Symptoms ◽

The Impact ◽

Her2 Positivity

IntroductionThe prognostic value of symptoms at disease presentation of advanced gastro-oesophageal cancer is unknown. Thus, the aim of this study was to characterise these symptoms and correlate them with the outcome, so new prognostic markers can be defined.MethodsWe analysed clinical data including symptoms, therapies and survival of patients with stage IV gastro-oesophageal cancer treated between 2002 and 2018 at the Vienna General Hospital, Austria. Initial symptoms as well as stenosis in endoscopy and HER2 positivity were evaluated in a cross-validation model to ascertain the impact of each variable on patient survival.ResultsIn total, 258 patients were evaluated. Five factors (stenosis in endoscopy, weight loss, HER2 positivity, dyspepsia, ulcer or active bleeding) have proven to be statistically relevant prognostic factors and were given a count of +1 and −1, if applicable. The resulting score ranges between −3 and +2. The survival probability for 180 days with a score of −3/–2, −1, 0, +1 and +2 is 90%, 80%, 73%, 72% and 42%, whereas for 2 years, it is 30%, 30%, 8%, 7% and 3%, respectively. The median overall survival of a score of −3/–2, −1, 0, +1 and +2 was 579 (95% CI 274 to not measurable), 481 (95% CI 358 to 637), 297 (95% CI 240 to 346), 284 (95% CI 205 to 371), 146 (95% CI 120 to 229) days, respectively.ConclusionThe data from this retrospective study indicate that the Viennese risk prediction score for Advanced Gastroesophageal carcinoma based on Alarm Symptoms score provides independent prognostic information that may support clinical decision making at diagnosis of advanced gastro-oesophageal cancer. Our findings should be evaluated in prospective studies.

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1608P The impact of COVID-19 on the delivery of systemic anti-cancer treatment at Guy’s Cancer Centre

Annals of Oncology ◽

10.1016/j.annonc.2021.08.1601 ◽

2021 ◽

Vol 32 ◽

pp. S1149

Author(s):

S. Dolly ◽

B. Russell ◽

C.L. Moss ◽

E. Tsotra ◽

C. Gousis ◽

...

Keyword(s):

Cancer Treatment ◽

Cancer Centre ◽

Anti Cancer ◽

The Impact

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Religion and Medicine

10.1093/oso/9780190867355.001.0001 ◽

2020 ◽

Author(s):

Jeff Levin ◽

Stephen G. Post

Keyword(s):

Clinical Decision Making ◽

Well Being ◽

Clinical Decision ◽

Religion And Medicine ◽

Physical And Mental Health ◽

Faith Based ◽

Baylor University ◽

Wide Range ◽

History Of ◽

The Impact

In Religion and Medicine, Dr. Jeff Levin, distinguished Baylor University epidemiologist, outlines the longstanding history of multifaceted interconnections between the institutions of religion and medicine. He traces the history of the encounter between these two institutions from antiquity through to the present day, highlighting a myriad of contemporary alliances between the faith-based and medical sectors. Religion and Medicine tells the story of: religious healers and religiously branded hospitals and healthcare institutions; pastoral professionals involved in medical missions, healthcare chaplaincy, and psychological counseling; congregational health promotion and disease prevention programs and global health initiatives; research studies on the impact of religious and spiritual beliefs and practices on physical and mental health, well-being, and healing; programs and centers for medical research and education within major universities and academic institutions; religiously informed bioethics and clinical decision-making; and faith-based health policy initiatives and advocacy for healthcare reform. Religion and Medicine is the first book to cover the full breadth of this subject. It documents religion-medicine alliances across religious traditions, throughout the world, and over the course of history. It summarizes a wide range of material of relevance to historians, medical professionals, pastors and theologians, bioethicists, scientists, public health educators, and policymakers. The product of decades of rigorous and focused research, Dr. Levin has produced the most comprehensive history of these developments and the finest introduction to this emerging field of scholarship.

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P9 A study to investigate the impact of the COVID-19 pandemic on paediatric cancer patients: an international, multicentre, observational cohort study (COVIDPaedsCancer)

BJS Open ◽

10.1093/bjsopen/zrab032.008 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

◽

Soham Bandyopadhyay

Keyword(s):

Cohort Study ◽

Cancer Treatment ◽

Childhood Cancer ◽

Multivariate Logistic Regression Analysis ◽

Global Health Research ◽

Cancer Outcomes ◽

Paediatric Cancer ◽

Cancer Management ◽

Anti Cancer ◽

The Impact

Abstract Introduction Childhood cancers are a leading cause of non-communicable disease deaths for paediatric patients around the world. The COVID-19 pandemic may have impacted on global children’s cancer services, which can have consequences for childhood cancer outcomes. The Global Health Research Group on Children’s Non-Communicable Diseases (Global Children’s NCDs) is currently undertaking the first international study to determine the variation in paediatric cancer management during the COVID-19 pandemic, and the short to medium term impacts on childhood cancer outcomes. Methods and analysis This is a multicentre, international, cohort study that will use routinely collected hospital data in a de-identified and anonymised form. Patients will be recruited consecutively into the study, with a 12 -month follow-up period. Patients will be included if they are below the age of 18 years and undergoing anti-cancer treatment for the following cancers: Acute lymphoblastic leukaemia, Burkitt’s Lymphoma, Hodgkin's lymphoma, Wilms Tumour, Sarcoma, Retinoblastoma, Gliomas, Medulloblastomas and Neuroblastomas. Patients must be newly presented or be undergoing active anti-cancer treatment from the 12th March 2020 to the 12th December 2020. The primary objective of the study is to determine 30- and 90-day all-cause mortality rates. This study will examine the factors that influenced these outcomes. Chi-squared analysis will be used to compare mortality between low and middle-income countries and high-income countries. Multilevel, multivariate logistic regression analysis will be undertaken to identify patient-level and hospital-level factors affecting outcomes with adjustment for confounding factors. Ethics and dissemination At the host centre, this study was deemed to be exempt from ethical committee approval due to the use of anonymised registry data. At other centres, participating collaborators have gained local approvals in accordance with their institutional ethical regulations. Collaborators will be encouraged to present the results locally, nationally, and internationally. The results will be submitted for publication in a peer reviewed journal.

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Celecoxib Analogues for Cancer Treatment: An Update on OSU-03012 and 2,5-Dimethyl-Celecoxib

Biomolecules ◽

10.3390/biom11071049 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1049

Author(s):

Cyril Sobolewski ◽

Noémie Legrand

Keyword(s):

Cancer Treatment ◽

Metabolic Diseases ◽

Catalytic Site ◽

Antitumor Effects ◽

Anti Cancer ◽

Cox 2 ◽

Cox 2 Inhibitors ◽

The Impact ◽

Important Enzyme ◽

Specific Inhibitors

Cyclooxygenase-2 (COX-2) is an important enzyme involved in prostaglandins biosynthesis from arachidonic acid. COX-2 is frequently overexpressed in human cancers and plays a major tumor promoting function. Accordingly, many efforts have been devoted to efficiently target the catalytic site of this enzyme in cancer cells, by using COX-2 specific inhibitors such as celecoxib. However, despite their potent anti-tumor properties, the myriad of detrimental effects associated to the chronic inhibition of COX-2 in healthy tissues, has considerably limited their use in clinic. In addition, increasing evidence indicate that these anti-cancerous properties are not strictly dependent on the inhibition of the catalytic site. These findings have led to the development of non-active COX-2 inhibitors analogues aiming at preserving the antitumor effects of COX-2 inhibitors without their side effects. Among them, two celecoxib derivatives, 2,5-Dimethyl-Celecoxib and OSU-03012, have been developed and suggested for the treatment of viral (e.g., recently SARS-CoV-2), inflammatory, metabolic diseases and cancers. These molecules display stronger anti-tumor properties than celecoxib and thus may represent promising anti-cancer molecules. In this review, we discuss the impact of these two analogues on cancerous processes but also their potential for cancer treatment alone or in combination with existing approaches.

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Clinical Conundrums When Integrating the QbTest into a Standard ADHD Assessment of Children and Young People

Neuropediatrics ◽

10.1055/s-0040-1722674 ◽

2021 ◽

Author(s):

Carsten Vogt

Keyword(s):

Clinical Practice ◽

Clinical Decision Making ◽

Ecological Validity ◽

Neuropsychological Test ◽

Real Life ◽

Clinical Decision ◽

Hyperactivity Disorder ◽

Standard Clinical Practice ◽

Novel Method ◽

The Impact

AbstractThe uptake of the QbTest in clinical practice is increasing and has recently been supported by research evidence proposing its effectiveness in relation to clinical decision-making. However, the exact underlying process leading to this clinical benefit is currently not well established and requires further clarification. For the clinician, certain challenges arise when adding the QbTest as a novel method to standard clinical practice, such as having the skills required to interpret neuropsychological test information and assess for diagnostically relevant neurocognitive domains that are related to attention-deficit hyperactivity disorder (ADHD), or how neurocognitive domains express themselves within the behavioral classifications of ADHD and how the quantitative measurement of activity in a laboratory setting compares with real-life (ecological validity) situations as well as the impact of comorbidity on test results. This article aims to address these clinical conundrums in aid of developing a consistent approach and future guidelines in clinical practice.

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AAC Assessment and Clinical-Decision Making: The Impact of Experience

Augmentative and Alternative Communication ◽

10.3109/07434618.2012.704521 ◽

2012 ◽

Vol 28 (3) ◽

pp. 148-159 ◽

Cited By ~ 42

Author(s):

Aimee Dietz ◽

Wendy Quach ◽

Shelley K. Lund ◽

Miechelle McKelvey

Keyword(s):

Decision Making ◽

Clinical Decision Making ◽

Clinical Decision ◽

The Impact

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Standardized Synoptic Cancer Pathology Reports — So What and Who Cares?: A Population-Based Satisfaction Survey of 970 Pathologists, Surgeons, and Oncologists

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2012-0656-oa ◽

2013 ◽

Vol 137 (11) ◽

pp. 1599-1602 ◽

Cited By ~ 37

Author(s):

Sara Lankshear ◽

John Srigley ◽

Thomas McGowan ◽

Marta Yurcan ◽

Carol Sawka

Keyword(s):

Decision Making ◽

Clinical Decision Making ◽

Clinical Decision ◽

Physician Satisfaction ◽

Cross Sectional ◽

Cancer Pathology ◽

Report Turnaround Time ◽

Significant Difference ◽

Pathology Reporting ◽

The Impact

Context.—Cancer Care Ontario implemented synoptic pathology reporting across Ontario, impacting the practice of pathologists, surgeons, and medical and radiation oncologists. The benefits of standardized synoptic pathology reporting include enhanced completeness and improved consistency in comparison with narrative reports, with reported challenges including increased workload and report turnaround time. Objective.—To determine the impact of synoptic pathology reporting on physician satisfaction specific to practice and process. Design.—A descriptive, cross-sectional design was utilized involving 970 clinicians across 27 hospitals. An 11-item survey was developed to obtain information regarding timeliness, completeness, clarity, and usability. Open-ended questions were also employed to obtain qualitative comments. Results.—A 51% response rate was obtained, with descriptive statistics reporting that physicians perceive synoptic reports as significantly better than narrative reports. Correlation analysis revealed a moderately strong, positive relationship between respondents' perceptions of overall satisfaction with the level of information provided and perceptions of completeness for clinical decision making (r = 0.750, P < .001) and ease of finding information for clinical decision making (r = 0.663, P < .001). Dependent t tests showed a statistically significant difference in the satisfaction scores of pathologists and oncologists (t169 = 3.044, P = .003). Qualitative comments revealed technology-related issues as the most frequently cited factor impacting timeliness of report completion. Conclusion.—This study provides evidence of strong physician satisfaction with synoptic cancer pathology reporting as a clinical decision support tool in the diagnosis, prognosis, and treatment of cancer patients.

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The impact of COVID 19 pandemic on pattern of cancer mortality in Najran, Saudi Arabia: a single-cancer center experience

10.21203/rs.3.rs-305960/v1 ◽

2021 ◽

Author(s):

Ahmed M Badheeb ◽

Mohamed A Badheeb ◽

Hamdi A Alhakimi

Keyword(s):

Hepatocellular Carcinoma ◽

Saudi Arabia ◽

Cancer Treatment ◽

Cancer Patients ◽

Cancer Mortality ◽

Cancer Center ◽

Anti Cancer ◽

Before And After ◽

The Difference ◽

The Impact

Abstract Background: The aim of this paper is to compare the patterns and determinants of cancer mortality in Najran region before and after the COVID-19 epidemics. The association between cancer mortality and each of age, sex, site of cancer, stage, and the 30-days survival rate after the last dose of chemotherapy were assessed.Materials & Methods: Adult cancer patients who died of cancer in King Khalid Hospital in Najran Saudi Arabia, were included in this retrospective observational study. We compared mortality patterns in a period of 6 months in 2020 (March to August) with the corresponding period of 2019.Results: 50 dead adult cancer patients were included, 24 in 2019 and 26 in 2020. Among them, 21% vs 42% were younger than 65 years of age; 61% vs 62% were males, for the years 2019 & 2020 respectively. The top three killers in 2019 were colorectal, gastro-esophageal cancers, and hepatocellular carcinoma, while in 2020 were colorectal, hepatocellular carcinoma, and lymphomas. About 16.7% of patients died within 30 days of receiving anti-cancer treatment in 2019 in comparison with 7.7% in 2020. The difference in the 30-days mortality after receiving anti-cancer treatment was not statistically significant between 2019 and 2020 (p = 0.329).Conclusion: The Year 2020, the time of the COVID-19pandemic, was not associated with a significant increase in short-term mortality among patients with malignancy in Najran, Saudi Arabia. Our results generally reflect the crucial role of strict preventive national measures in saving lives and warrants further exploration.

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Clinicians’ experiences of using and implementing a medical mobile phone app (QUiPP V2) designed to predict the risk of preterm birth and aid clinical decision making

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01681-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

N. Carlisle ◽

H. A. Watson ◽

J. Carter ◽

K. Kuhrt ◽

P. T. Seed ◽

...

Keyword(s):

Decision Making ◽

Preterm Birth ◽

Cultural Context ◽

Clinical Decision Making ◽

Qualitative Interviews ◽

Scale Up ◽

Clinical Decision ◽

Clinical Trial Registry ◽

Support Tool ◽

The Impact

Abstract Background As the vast majority of women who present in threatened preterm labour (TPTL) will not deliver early, clinicians need to balance the risks of over-medicalising the majority of women, against the potential risk of preterm delivery for those discharged home. The QUiPP app is a free, validated app which can support clinical decision-making as it produces individualised risks of delivery within relevant timeframes. Recent evidence has highlighted that clinicians would welcome a decision-support tool that accurately predicts preterm birth. Methods Qualitative interviews were undertaken as part of the EQUIPTT study (The Evaluation of the QUiPP app for Triage and Transfer) (REC: 17/LO/1802) which aimed to evaluate the impact of the QUiPP app on management of TPTL. Individual semi-structured telephone interviews were used to explore clinicians’ (obstetricians’ and midwives’) experiences of using the QUiPP app and how it was implemented at their hospital sites. Thematic analysis was chosen to explore the meaning of the data, through a framework approach. Results Nineteen participants from 10 hospital sites in England took part. Data analysis revealed three overarching themes which were: ‘experience of using the app’, ‘how QUiPP risk changes practice’ and ‘successfully adopting QUiPP: context is everything’. With these final themes we appeared to have achieved our aim of exploring the clinicians’ experiences of using and implementing the QUiPP app. Conclusion This study explored different clinician’s experiences of implementing the app. The organizational and cultural context at different sites appeared to have a large impact on how well the QUiPP app was implemented. Future work needs to be undertaken to understand how best to embed the intervention within different settings. This will inform scale up of QUiPP app use across the UK and ensure that clinicians have access to this free, easy-to-use tool which can positively aid clinical decision making when caring for women in TPTL. Clinical trial registry and registration number ISRCTN 17846337, registered 08th January 2018, https://doi.org/10.1186/ISRCTN17846337.

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